Objective To determine the feasibility and the optimal dose reduction of AIDR 3D on piglet chest CT which can provide image quality (IQ) comparable to filtered back projection (FBP).Methods Twenty-nine normal pigs with the weight of 3-12kg underwent 640-slice MDCT chest CT (Aquilion one,Toshiba) for 5 times with 80 kvp and various mAs.SureExposure3D technique were used and the index of noise were set to SD 10.0,12.5,15.0,17.5,20.0(Group A,B,C,D,E) to reduce dose successively.Group A were reconstructed with FBP,Group B,C,D,E were reconstructed using AIDR 3D (strong level).Quantitative image noise and signal to noise ratio(SNR) were measured in each group.Two radiologists graded subject image quality on both lung images (artifacts,central airway,lung tissue) and mediastinal images (mediastinal structure) and overall image quality using a 5-point scale in a blinded manner.Analysis of variance (ANOVA) and LSD test were used for comparisons of objective evaluation indices (CT value,noise,SNR)and radiation dose(CTDIvo1,DLP,ED) among the five groups.The Friedman test and Wilcoxon test were used for comparisons of demographic data and for detection of differences in subjective evaluation of IQ among groups.A receiver-operating characteristic (ROC) analysis was performed to establish a radiation reduction threshold up to which comparable IQ(score≥4) was maintained.Results Compared with Group A[noise(15.25 ± 3.14)HU,SNR 3.23 ± 1.07],Group B,C had significant lower noise and higher SNR [noise (12.11 ± 2.75),(13.18 ± 3.16)HU; SNR 4.13 ± 1.38,3.80 ± 1.20;F =7.38,3.11,P ＜0.05].Group D,E showed no significantly different noise and SNR with Group A[noise (15.14±4.51),(15.79 ±4.17)HU;SNR 3.40± 1.56,3.45 ± 1.70;P＞0.05].Group B,C had significant better subject image quality compared with Group A (P ＜0.01).Group D had no significantly different subject image quality compared with Group A (P ＞ 0.05).Group E had 5 pigs with overall image scores of ＜ 3.The ROC curve of IQ established SD 17.5 (Group D) as optimal cut-off point (AUC 0.75,95％ CI 0.58-0.92).Group D provided equivalent subjective image score and objective IQ measurements compared with FBP images in Group A.The ED of group D was 59％ lower than that of group A[CTDIvol (1.14±0.27) mGy vs (0.47 ±0.16)mGy,F=183.83,P＜0.01].Conclusion Using AIDR 3D technique,80 kvp with SureExposure3D (SD 17.5) can provide comparable IQ compared with routine dose with FBP reconstruction,and reduce 59％ dose in piglet model.

Objective:To analyze the features of the connective tissue associated interstitial lung disease (CTD-ILD) by high resolution computed tomography (HRCT).Methods:A total of 127 patients with CTD-ILD,who were diagnosed by clinic laboratory examination and pathology in Xiangya Hospital of Central South University form September 2013 to September 2015,were enrolled for this study.Their lung features of HRCT imaging were retrospectively analyzed.Results:The classifications for 127 patients were as follows:36 cases of rheumatoid arthritis (28.3%),34 cases of dermatomyositis and polymyositis (26.8%),31 cases of systemic sclerosis (24.4%),18 cases of Sj(o)gren syndrome (14.2%),7 cases of mixed connective tissue disease (5.5%),and 1 cases of systemic lupus erythematosus (0.8%).According to the features of HRCT imaging,the patients were divided as follows:77 cases (60.6%) ofnonspecific interstitial pneumonia (NSIP),46 cases (36.2%) of usual interstitial pneumonia (UIP),2 cases (1.6%) of lymphocytic interstitial pneumonia (LIP),1 case (0.8%) of cryptogenic interstitial pneumonia (COP),and 1 case (0.8%) of acute interstitial pneumonia (AIP).The HRCT findings for 36 cases of rheumatoid arthritis associated interstitial lung disease were UIP (24 cases,66.7%) and NSIP (12 cases,33.3%);the HRCT findings for 34 cases of dermatomyositis and polymyositis associated interstitial lung disease were NSIP (32 cases,94.1%),UIP (1 case,2.9%) and COP (1 case,2.9%);the HRCT findings for 31 cases of systemic sclerosis associated interstitial lung disease were NSIP (21 cases,67.8%),UIP.(9 cases,29%),LIP(1 case,3.2%);the HRCT findings for 18 cases of Sj(o)gren syndrome associated interstitial lung disease were NSIP (9 cases,50.0%),UIP (8 cases,44.4%),LIP (1 case,5.6%);the HRCT findings for 7 cases of mixed connective tissue disease associated interstitial lung disease were UIP (4 cases,57.1%),NSIP (3 cases,42.9%).SLE-ILD was rare,with only 1 case of AIP.Conclusion:Different types of CTD-ILD patients display relatively unique manifestation of HRCT.

Purpose To study the clinicopathological characteristics in 22 cases of ovarian mature teratoma with malignant transforma-tion. Methods Clinical and pathologic features were collected and analyzed in 22 out of 1 826 cases of ovarian mature teratoma by retrospective studies, together with immunohistochemical staining. Results In our study, 22 cases (1. 2%) of ovarian mature terato-ma with malignant transformation were identified. The median age was 56. 5 (range, 31~79) years. The main clinical manifestations were pelvic masses, including 13 cases in the left ovary, 8 cases in the right, 1 case was bilateral. Gross cystic teratoma were saw in 19 cases, 3 cases of cystic and solid, the bilateral one was solid in the left which the right was cystic. The teratomas size were 5. 0~30 cm with average 12. 4 cm in diameter. The malignant components’ maximum diameter was about 1. 0~10. 0 cm with average 3. 7 cm. Microscopicically, there were poorly differentiated squamous cell carcinoma in 14 cases, carcinoid carcinoma in 4 cases, adeno-carcinoma in 2 cases, papillary thyroid carcinoma in 2 cases, and the last one was sarcomatoid carcinoma. The FIGO stage distribution was as follows:16 were stage IA, 1 was stage IB, 1 was stage IIA, 4 were stage IIB. Follow up showed 6 cases recurrened, 2 patients died, the rest are survival. Conclusions A low incidence of ovarian mature teratoma in somatic cells with malignant transformation, which are common in postmenopausal women and present with pelvic mass. The main malignant components is squamous cell carcino-ma, patients of stage I have better prognosis. Both clinic and pathology should take more attention to the comprehensive examination and diagnosis of teratoma for prevent misdiagnosis.

Objective To understand the diagnostic values of procalcitonin (PCT),C-reactive protein (CRP),erythrocyte sedimentation rate (ESR),white blood cell (WBC) and neutmphilic granulocyte ratio (NE％) in distinguishing concurrent bacterial infection from idiopathic inflammatory myopathy (ⅡM).Methods Clinical data and laboratory examinations of 118 ⅡM patients were collected.The ⅡM patients were assigned to the bacterial infection group (n=66) or the non-infection group (n=52).The levels of PCT,CRP,ESR,WBC and NE％ were compared by the Mann-Whitney U tests between the two groups and receiver operating characteristic curves were generated in order to evaluate the diagnostic value.Results The levels of PCT (0.06 ng/ml,0.03 ng/ml,U=2.637,P＜0.01);CRP (15.80 mg/L,4.40 mg/L,U=5.944,P＜0.01);ESR (43.50 mm/1 h,27.00 mm/1 h,U=2.266,P＜0.05);WBC (9.85×109/L,7.70×109/L,U=2.675,P＜0.01) and NE％ (80.70％,75.75％,U=2.344,P＜0.01) were significantly higher in the ⅡM patient group with concurrent infection than in the noninfection ⅡM patient group.CRP showed the highest diagnostic value with sensitivity,specificity,positive predictive value and negative predictive value of 72.7％,82.7％,84.2％ and 70.5％,respectively.Conclusion The inflammatory biomarkers PCT,CRP,ESR,WBC and NE％ offer diagnostic accuracy in detecting bacterial infection in ⅡM patients.Particularly,CRP is the most sensitive and specific biomarker indetecting bacterial infection in ⅡM patients.

Objective To study the effect of heterogeneity in different parts of acute and chronic deep venous thrombus on the ultrasound shear wave elasticity value.Methods Fifteen Japanese rabbits were used to create an inferior vena cava (IVC) thrombus model via IVC ligation.Young's modulus of the thrombus head,body and tail were measured using ultrasonic shear wave elasticity technique on the fifth day (acute phase) and 14th day (chronic phase) of thrombus formation.Pathological sections were obtained from the IVC thrombus in five rabbits at the two points of time mentioned above.Pair t-test and one-way analysis of variance (ANOVA) were used to compare the data between groups.Results On the fifth day,Young's modulus values of the thrombus head,body and tail were (5.73 ±0.47)kPa,(7.82±0.63)kPa and (4.76±0.45)kPa respectively.ANOVA showed significant difference among three parts (F=134.468,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the head and tail (both P ＜ 0.01),and the value of the head was significantly higher than that of the tail (P ＜ 0.01).On the 14th day,Young's modulus values of the thrombus head,body and tail were (12.46 ± 2.59)kPa,(15.08 ±2.71)kPa and (10.03 ± 2.02)kPa,respectively.ANOVA analysis also showed significant difference among three parts (F=10.539,P ＜ 0.01).The value of the thrombus body was significantly higher than that of the tail (P ＜ 0.01),and also higher than that of the head,although the difference was not significant (P ＞ 0.05).There was no significant difference between the head and tail (P ＞ 0.05).Young's modulus values of the thrombus head,body and tail in the chronic phase were significantly higher than those in the acute phase (t=-7.456,-7.989 and-8.159,respectively,all P ＜ 0.01).Pathological results showed that there was significant difference in thrombus structure and composition among different parts of the thrombus and among the thrombi in different individuals at corresponding points of time following thrombus formation.Conclusion There is significant heterogeneity among different parts of the same thrombus and among different thrombi at corresponding points of time after thrombus formation.Continual monitoring of the thrombus with ultrasound elasticity imaging may help to improve the accuracy of thrombosis staging.

Objective:By using the network pharmacology method to predict the active constituents and action targets of Suzi-Jiangqi Decoction in the treatment of COPD, and to explore its potential molecular mechanism with multi-component, multi-target and multi-pathway characteristics. Methods:The active constituents and targets of Suzi-Jiangqi Decoction were collected, screened and predicted according to the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and UniProt software. Search for the gene targets related to COPD in GeneCards, online human Mendelian genetic database (OMIM) and TTD database. The intersection targets of component targets and disease targets were obtained by Veen map online software. The network model with the sequence of active constituents-target-disease was constructed and analyzed by Cytoscape software, and the protein-protein interaction network (PPI) was constructed by STRING database. The gene ontology function annotation (GO) and Tokyo genome encyclopedia (KEGG) pathway enrichment analysis of common targets with metascape online tool. Results:A total of 163 active constituents of Suzi-Jiangqi Decoction were screened, 283 targets were predicted, and 159 targets involved in the treatment of COPD. Quercetin, kaempferol, naringin and luteolin were the key active ingredients. IL6, TNF, MAPK3, JUN, CASP3, CXCL8, CXCL10, MMP9 and MAPK1 were important gene targets. GO analysis showed that the biological processes involved in the enrichment of key gene targets included the response to bacteria, the cytokine mediated signaling pathway, the cell's response to inorganic substances, the response to oxidative stress, the response to LPS, and so on. The enrichment analysis of KEGG pathway showed that the signaling pathway of Suzi-Jiangqi Decoction in the treatment of COPD included TNF signaling pathway, IL-17 signaling pathway, cell cycle, Influenza A, HTLV-I infection, AGE-RAGE signaling pathway, Tuberculosis, Epstein-Barr virus infection and so on. Conclusion:Suzi-Jiangqi Decoction can treat COPD through multi-target and multi-pathway mechanisms of anti-inflammatory, anti infection and immune regulation, which lays a foundation for further study of its molecular mechanism.

Objective To discuss the clinical effect of transcranial magnetic stimulation in treatment of dysfunction and depression of parkinson disease patients. Methods A totao of 50 cases of parkinson patients were randomly divided into the observation group and the control group, each group 25 cases, the control group was given conventional medicine and rehabilitation training, the observation group was given low frequency repetitive transcranial magnetic stimulation based on the control group. Results After 1 months of treatment, UPDRS Ⅰ, UPDRS II, UPDRS III, UP-DRS total scores in the observation group were lower than that in the control group, there was statistical significance (P<0.05). Compared MMSE scores between the observation group and the control group, there was no statistical sig-nificance (P>0.05), but HAMD score in the observation group was lower than that in the control group, there was statis-tical significance (P<0.05). Conclusion Low frequency repetitive transcranial magnetic stimulation can be used as a non-invasive measure of physical therapy for parkinson's disease.

Objective To explore the effects of mindfulness training combined with auricular acupressure on sleep quality and negative emotion in patients with stroke. Methods Totally 70 stroke patients hospitalized in Rehabilitation Department of the First Affiliated Hospital of Harbin Medical University between October and December 2018 were selected by convenient sampling, and randomly divided into the observation group (n=35) and the control group (n=35). Patients in the control group received routine rehabilitation nursing, while patients in the observation group received mindfulness training combined with auricular acupressure on this basis. The Pittsburgh Sleep Quality Index Scale (PSQI), Self-Depression Scale (SDS) and Self-Anxiety Scale (SAS) were used to evaluate the sleep quality and negative emotion of the two groups of patients before and after the intervention. Results After the intervention, the PSQI, SDS, and SAS scores of the observation group were lower than those of the control group, and the differences were statistically significant (P< 0.05). Conclusions Mindfulness training combined with auricular acupressure can effectively ameliorate the sleep quality and negative emotion in patients with stroke.

Objective To investigate the prevalence of sleep disorders and the relevant determinants in a cohort of systemic lupus erythematosus (SLE) patients.Methods One hundred patients with SLE were included in the study.Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI).Depression,anxiety,quality of life,and fatigue were evaluated by patient health questionnaire (PHQ)-9,generalized anxiety disorder (GAD)-7,short form 36 health survey (SF-36),and visual analogue scale (VAS) respectively.The demographic and clinical data were also recorded.SLE disease activity and damage severity were assessed by systemic lupus erythematosus disease activity index (SLEDAI) and systemic lupus erythematosus damage index (SDI) respectively.Mann-Whitnry U test,t test,Logistic regression were used for statistically analysis.Results The prevalence of sleep disorders in SLE patients was 42％.Compared with patients without sleep disorders,the ratio of males and married patients,age,the score of SDI,PHQ-9,GAD-7,and fatigue were higher in SLE patients with sleep disorders,while the score of SF-36 was lower (r＜0.05).Age,SLEDAI,SDI,PHQ-9,GAD-7,and fatigue correlated positively with sleep disorders (The values of r were 0.215,0.230,0.311,0.529,0.455,0.541,P＜0.05).C3 and the score of SF-36 correlated negatively with sleep disorders (The values of r were-0.204,-0.342,-0.490,-0.464,-0.497,-0.590,-0.428,-0.478,-0.398,-0.412,-0.659respectively,P＜0.05).In multi-ple logistic regression analyses,gender (OR=22.22),anxiety (OR =2.895),body pain (OR =0.964),and energy (OR =0.947) were the independent determinants of sleep disorders (R2=0.494,P＜0.01).Conclusion Poor sleep quality is common in SLE patients.Gender,age,disease activity and severity,anxiety,depressed mood,and quality of life contribute significantly to sleep disorders in SLE.

Objective:To analyze the trend relevant factors leading to death and their patterns over a 10-year period in inpatients with connective tissue diseases (CTDs).Methods:All clinical data about death in inpatients with CTDs were retrospectively reviewed between 2005 and 2014 at the Department of Rheumatology and Immunology in Xiangya Hospital of Central South University.Results:In the 10-year time period,the overall hospital mortality was 15.689‰.The disease itself accounted for 44.71% of the total causes of death,infection accounted for 42.94%,and comorbidities accounted for 12.35%.The constituent ratio of deaths and the average hospital mortality caused by the disease itself declined gradually year by year,and the constituent ratio of deaths caused by infection and comorbidities increased gradually year by year (P<0.05).In 2013-2014,infection was the leading cause of death,which accounted for 51.06%.The survival time for CTDs inpatients with interstitial lung disease (ILD) was shorter than that of CTDs inpatients without ILD,and even the risk of death was 1.722 times of the latter.The proportion of deaths caused by the disease itself was the highest in systemic sclerosis and systemic lupus erythematosus,that by infection was the highest in idiopathic inflammatory myopathy (IIM),and that by comorbidities was the highest in rheumatoid arthritis.Conclusion:The proportion of deaths and the hospital mortality in CTDs inpatients caused by the disease itself show a declining trend,while the proportion of deaths caused by infection and comorbidities increase.CTDs patients with ILD have shorter survival time and an increase in risk of death.